腎移植術後のAcute on chronic rejectionに対する15-deoxyspergualinの間歇投与の経験

Abstract

生体腎移植術後のAOCRに対してDSGの間歇投与を行い, 治療効果及び副作用について検討した.今回半数の症例が著効と判定されたが, 治療効果と関連を認めたのは病理学的所見のうちacute rejectionのgradeであった.副作用については1例に重篤な骨髄抑制が認められたが, DSGを含む各種免疫抑制剤の投与中止後に軽快した

We used 15-deoxyspergualin (DSG) to treat acute on chronic rejection (AOCR) in six kidney transplant recipients. DSG was administered intermittently at a dose of 200-300 mg per body every 2 or 4 weeks for more than 6 months. The efficacy of DSG was evaluated by the changes in serum creatinine values during the rejection therapy. Four (67%) of the six patients responded with the suppression of the increase in serum creatinine values. On the other hand, one patient did not respond at all and developed advanced pancytopenia. These findings suggested that intermittent administration of DSG would be efficient therapy on AOCR in the renal allografts if the patients were treated carefully to prevent severe side effects.